The only Planned Parenthood office in Wyoming will close along with another five offices in the organization’s Rocky Mountain region, though officials said it would still exercise a presence in the state.

The organization’s Casper clinic opened in 1975 and served about 480 clients each year. While Planned Parenthood is the largest abortion provider in the U.S., the Casper clinic’s services include abortion referrals, not abortions themselves. The clinic is set to close July 21.

North Dakota is the only other U.S. state without a Planned Parenthood location.

Planned Parenthood of the Rocky Mountains official Adrienne Mansanares, speaking to the Casper Star-Tribune, said the organization looked at the services and financial health of the Wyoming clinic. Most Planned Parenthood patients in the state go to the Fort Collins, Colorado location.

The Casper clinic has been staffed by a part-time manager and a traveling nurse who visits from northern Colorado.

Planned Parenthood will continue its presence in the state through the Wyoming Abortion Fund, which connects women to abortionists. The organization will continue to offer sex education resources, and its advocacy work will also continue in collaboration with NARAL Pro-Choice Wyoming.

“The political footprint and the education we provide will continue to remain,” said Mansanares.

Whitney Phillips, spokesperson for Planned Parenthood of the Rocky Mountains, said the capacity of other Casper providers to supply comprehensive reproductive health care was a factor in the decision to close the clinic. Patients are being referred to several other providers in Casper.

Planned Parenthood’s Rocky Mountain region includes Colorado, New Mexico, Wyoming, and southern Nevada. The Longmont and Parker, Colorado offices will also close, as will New Mexico offices in Albuquerque, Rio Rancho, and Farmington.

In a May 17 statement, Phillips said the closures are “difficult but necessary organizational changes” driven by a desire for long-term sustainability.

“This strategic decision will allow us to maintain a fiscally solvent operation that will keep our doors open to patients in the region for the long term,” she said.

The organization’s abortion work has always been controversial, but it has come under severe scrutiny since 2015, when undercover journalists with the Center for Medical Progress recorded Planned Parenthood staff and leaders appearing to plan the sale of aborted baby parts and fetal tissue for profit, which is illegal under federal law.

The Center for Medical Progress videos strengthened efforts to defund the abortion provider, which has received about $500 million in federal funding each year for non-abortion services. Planned Parenthood and its allies responded to the videos with a multi-million dollar publicity campaign to control the damage.

Two videos released in July 2015 appeared to show Planned Parenthood of the Rocky Mountains vice president and medical director Savita Ginde negotiate the sale of aborted baby parts.

The Planned Parenthood affiliate also recently settled a civil lawsuit alleging that two of its employees failed to comply with Colorado law by performing an abortion on a 13-year-old girl who was sexually abused. The lawsuit said employees neglected to report the abuse of a minor to authorities or obtain consent from her parents prior to performing the abortion.

Planned Parenthood of the Rocky Mountains also contested a 2013 lawsuit by the former executive director of Colorado Department of Public Health and Environment regarding $14 million of taxpayer subsidies that the group received from the state despite a Colorado constitutional amendment prohibiting the use of tax dollars to fund abortions.

In November 2015, a man fatally shot three and wounded nine in attacks at a Planned Parenthood clinic in Colorado Springs. He was later ruled mentally unfit for trial. One victim’s widow, who was wounded in the attack, filed a lawsuit charging that the clinic should have had better security given the history of attacks on clinics.